Older people’s preferences for elderly care mode in Northwest China: a multilevel analysis stratified by socioeconomic status

Geriatric care refers to meeting the unique health and social needs of older adults, which is associated with socioeconomic status (SES). However, the influence of SES and how to integrate SES into decision-making of elderly care models have not been well studied in China. This study aims to explore the preferences of elderly people of different SES in China for elderly care models. We collected data of 190,401 older adults (mean age 74.8 years) regarding the preferences of long-term care (LTC) models using questionnaire surveys. Information on SES, including employment, annual income, and educational background, has all been collected. Multivariate logistic regression was used to identify the socioeconomic factors associated with the care preferences of older adults. Home care was the most frequently mentioned preferred mode (88.6%), followed by 5% community, and 5% institution. Nearly half (49.1%) of older adults were in the poor SES group, which had a significant effect on their preference of the elderly care modes. Those with poor SES chose traditional home care as their preferred mode. The SES level has a much higher contribution rate than other factors, and subsequently annual income has the highest contribution (40.58%) to the preference. Our findings indicate that it may be difficult to generalize which model of elderly care is beneficial for older adults. This is a critical area for research to meet the growing need for LTC among increasing numbers of older adults in resource-limited settings. From a research perspective, our findings highlight the need to better understand the reasons behind certain preferences so that older adults can receive care in the mode they desire.